A surgical device includes a handle assembly, an elongated body, and a tool assembly. The handle assembly includes an actuation assembly operatively associated with an actuation shaft to advance the actuation shaft and configured to prevent advancement of the actuation shaft when the actuation shaft is in a fully retracted position and a moveable handle is in a non-compressed position and/or to prevent advancement of the actuation shaft when a grasping pawl is extended within a grasping slot of the actuation shaft. The actuation shaft including a vertical pawl locking surface near a distal end configured to engage a locking notch of a vertical pawl. The actuation assembly including a grasping pawl having a radial detent configured to engage a proximal surface of a grasping slot of the actuation shaft when the grasping pawl is positioned within the grasping slot.
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1. A surgical device comprising:
a handle assembly including a housing, an actuation shaft, a stationary handle, and a movable handle, the movable handle being moveable in relation to the stationary handle from a non-compressed position to a compressed position and being operably associated with the actuation shaft such that movement of the movable handle towards the compressed position effects axial movement of the actuation shaft;
an elongated body extending distally from the handle assembly, the elongated body defining a longitudinal axis;
a tool assembly supported on a distal end of the elongated body, the tool assembly including a cartridge assembly having a plurality of staples supported therein and an anvil assembly, the anvil assembly and the cartridge assembly being movable in relation to each other between open and closed positions; and
an actuation assembly supported within the housing, the actuation assembly being positioned to translate movement of the movable handle into linear movement of the actuation shaft to advance the actuation shaft, the actuation assembly including a locking assembly configured to prevent the actuation shaft from advancing when the actuation shaft is in a fully retracted position and the moveable handle is in the non-compressed position.
13. A surgical device comprising:
a handle assembly including an actuation shaft, a stationary handle, and a movable handle, the actuation shaft defining an actuation slot, the movable handle being moveable from a non-compressed position to a compressed position and being operably associated with the actuation shaft such that movement of the movable handle effects axial movement of the actuation shaft;
an elongated body extending distally from the handle assembly, the elongated body defining a longitudinal axis;
a tool assembly supported on a distal end of the elongated body, the tool assembly including a cartridge assembly having a plurality of staples supported therein and an anvil assembly, the anvil assembly and the cartridge assembly being movable in relation to each other between open and closed positions; and
an actuation assembly operatively associated with the actuation shaft to advance the actuation shaft upon movement of the moveable handle, the actuation assembly including a grasping pawl moveable between an extended position, wherein the grasping pawl is positioned within the grasping slot of the actuation shaft, and a retracted position, wherein the grasping pawl is positioned below the actuation shaft, the grasping pawl defining a recess positioned to receive a surface of the actuation shaft defining the grasping slot, wherein the recess is configured such that distal movement of the actuation shaft, when received in the recess, urges the grasping pawl towards the extended position.
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1. Technical Field
The present disclosure relates to a surgical stapling device and, more particularly, to a surgical stapling device including a safety device to prevent inadvertent firing of staples.
2. Background of Related Art
Surgical devices wherein tissue is first grasped or clamped between opposing jaw structure and then joined by surgical fasteners are well known in the art. The fasteners are typically in the form of surgical staples, but two-part polymeric fasteners can also be utilized.
Such devices can include a tool assembly with a pair of jaws which are used to capture or clamp tissue. Typically, one of the jaws carries a staple cartridge which houses a plurality of staples arranged, for example, in at least two lateral rows while the other jaw supports an anvil that defines a surface for forming the staple legs as the staples are driven from the staple cartridge. The stapling operation may be effected by cam bars that travel longitudinally through the staple cartridge and act on staple pushers for sequentially ejecting the staples from the staple cartridge. The stapling device can include a knife which travels between the staple rows for longitudinally cutting the stapled tissue between the rows of staples. Known staplers are disclosed in U.S. Pat. Nos. 6,250,532 and 6,241,139, each of which is commonly owned with the present disclosure, and is incorporated herein by reference in its entirety.
In endoscopic and laparoscopic procedures (hereinafter “endoscopic procedures”), surgery is performed through small incisions or through small diameter cannulas inserted through small entrance wounds in the skin. Thus, access to the surgical site is limited. During an endoscopic procedure, it is often necessary to manipulate tissue to properly position the tissue between the jaws of the surgical device. Some known endoscopic and laparoscopic surgical devices have firing and grasping modes of operation. In the grasping mode of operation, a trigger is operable to open and close the jaws to grasp and manipulate tissue. In the firing mode of operation, the trigger is operable to staple and cut tissue. It would be of great benefit to provide a stapling device which includes a safety feature to prevent inadvertent firing of staples.
According to an aspect of the present disclosure, a surgical stapling device is provided which incorporates a grasping function and a safety mechanism to prevent the stapling device from premature firing of the staples. The surgical stapling device includes a handle assembly, an elongated body, a tool assembly, and an actuation assembly. The handle assembly includes an actuation shaft, a stationary handle, and a moveable handle. The moveable handle has a non-compressed position positioned away from the stationary handle and is compressible towards the stationary handle such that movement of the moveable handle effects axial movement of the actuation shaft. The elongated body extends distally from the handle assembly and defines a longitudinal axis. The tool assembly is supported on a distal end of the elongated body. The tool assembly includes a cartridges assembly having a plurality of staples therein and an anvil assembly. The cartridge assembly and the anvil assembly are movable in relation to each other between open and closed positions. The actuation assembly is operatively associated with the actuation shaft to advance the actuation shaft upon movement of the moveable handle. The actuation assembly is configured to prevent the actuation shaft from advancing when the actuation shaft is in a fully retracted position and the moveable handle is in the non-compressed position.
In embodiments, the actuation assembly includes a vertical pawl having a locking notch and the actuation shaft includes a vertical pawl locking surface. The locking notch of the vertical pawl engages the vertical pawl locking surface when the actuation shaft is in the fully retracted position and the moveable handle is in the non-compressed position to prevent advancement of the actuation shaft. In some embodiments, the actuation assembly includes a disconnect link operatively associated with the moveable handle having a ramp extending distally from a proximal end. The ramp configured to engage a slot of the vertical pawl to move the vertical pawl out of engagement with the actuation shaft when the moveable handle is compressed. In particular embodiments, the actuation assembly includes an actuation pawl pivotally coupled to the moveable handle, an actuation arm, an actuation button moveable between a first or centered position and a second or non-centered position and a grasping pawl coupled to an end of the actuation arm. The grasping pawl moveable between an extended position, when the actuation button is in the centered position, and a retracted position, when the actuation button is in the off-centered position. When the grasping pawl is in the extended position the grasping pawl is positioned within a grasping slot of the actuation shaft and in the retracted position the grasping pawl is out of engagement with the actuation shaft. The grasping pawl can be configured to prevent the action shaft from advancing when the grasping pawl is in the extended position. In certain embodiments, the grasping pawl includes a radial detent configured to engage a distal surface of the grasping slot of the actuation shaft when the grasping pawl is in the extended position to prevent advancement of the actuation shaft.
According to other aspects of the present discourse, a surgical stapling device includes a retraction assembly having a retraction handle operatively associated with a release plate. The release plate is configured to extend below a portion of the actuation shaft to disengage a vertical pawl from the action shaft when the retraction handle is pulled proximally to retract the actuation shaft. In embodiments, the release plate extends below the actuation shaft from a fire mode locking surface to a proximal end of the actuation shaft. In some embodiments, the vertical pawl engages the actuation shaft from a grasping chamfer to a vertical pawl locking surface as the actuation shaft is retracted.
According to yet another aspect of the present disclosure, a surgical stapling device includes a handle assembly, an elongated body, a tool assembly, and an actuation shaft. The handle assembly includes an actuation shaft, a stationary handle, and a moveable handle. The moveable handle has a non-compressed position positioned away from the stationary handle and is compressible towards the stationary handle such that movement of the moveable handle effects axial movement of the actuation shaft. The elongated body extends distally from the handle assembly and defines a longitudinal axis. The tool assembly is supported on a distal end of the elongated body. The tool assembly includes a cartridges assembly having a plurality of staples therein and an anvil assembly. The cartridge assembly and the anvil assembly are movable in relation to each other between open and closed positions. The actuation assembly is operatively associated with the actuation shaft to advance the actuation shaft upon movement of the moveable handle. The actuation assembly includes a grasping pawl moveable between an extended position and a retracted position. In the extended position the grasping pawl is positioned within a grasping slot of the actuation shaft and is configured to prevent advancement of the actuation shaft. In the retracted position, the grasping pawl is positioned below the actuation shaft. In embodiments the grasping pawl includes a redial detent configured to engage a distal surface of a grasping slot of the actuation shaft when the grasping pawl is in the extended position to prevent advancement of the actuation shaft. In some embodiments, the actuation assembly is configured to prevent the actuation shaft from advancing when the actuation shaft is in a fully retracted position and the movable handle is in the non-compressed position. The actuation assembly can include a vertical pawl having a locking notch and a the actuation shaft can have a vertical pawl locking surface configured to engage the locking notch when the actuation shaft is in a fully retracted position and the moveable handle is in the non-compressed position.
Embodiments of the presently disclosed surgical stapling device are disclosed herein with reference to the drawings wherein:
Embodiments of the presently disclosed surgical stapling device including a universal handle safety mechanism will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Throughout this description, the term “proximal” will refer to the portion of the device closest to the clinician and the term “distal” will refer to the portion of the device furthest from the clinician.
Cartridge assembly 26a houses a plurality of staples and is movable in relation to anvil assembly 27a between an open position spaced from anvil assembly 27a and an approximated or closed position in juxtaposed alignment with anvil assembly 27a. Tool assembly 25 may be arranged such that cartridge assembly 26a is moveable and anvil assembly 27a is stationary (as shown) or, alternatively, such that anvil assembly 27a is movable and cartridge assembly 26a is stationary or such that both the anvil assembly 27a and the cartridge assembly 26a are movable. In an embodiment, tool assembly 25 is configured to apply linear rows of staples measuring from about 30 mm to about 60 mm in length (including about 45 mm in length) to tissue clamped between the cartridge assembly 26a and the anvil assembly 27a. Tool assemblies having linear rows of staples of other lengths and/or different staple array configurations are also envisioned. In embodiments, cartridge assembly 26a can be removably supported on first jaw 26 to facilitate reuse of stapling device 10 without replacement of reload 20 and/or where stapling device 10 does not include a reload 20.
Handle assembly 12 includes a housing 13 having a barrel portion 15 and a stationary handle 18. A movable handle 19 is pivotally supported on housing 13 adjacent stationary handle 18. In an embodiment, housing 13 is formed from molded half-sections 13a, 13b which are joined together by ultrasonic welding, adhesives, mechanical fasteners, or the like. A rotation control member 22 is rotatably mounted at the forward end of barrel portion 15 to facilitate rotation of elongated body 14 with respect to handle assembly 12. Rotation control member 22 also can be formed from molded plastic half-sections, although other materials, e.g., metals, and manufacturing methods are envisioned. An articulation lever 24 can also be mounted on the forward end of barrel portion 15 adjacent rotation control member 22 to facilitate articulation of tool assembly 25. U.S. Pat. No. 5,865,361 to Milliman et al. (the “'361 Patent”) and U.S. Pat. No. 7,967,178 to Scirica et al. (the “'178 Patent”), describe a rotation control assembly and articulation assembly for a surgical stapling apparatus each of which is commonly owned with the present disclosure and is hereby incorporated herein by reference in its entirety.
Referring now to
Referring to
Locking assembly 50 is moveable between an engaged position (
Referring to
With continued reference to
Actuation arm 144 and grasping pawl 142 are moveable between an extended position (
With continued reference to
In a grasping mode as shown in
When device 10 is in the grasping mode, movable handle 19 is prevented from moving to the non-compressed position by engagement of grasping pawl 142 with proximal surface 97a defining the grasping slot 97. More specifically, grasping pawl 142 is positioned within grasping slot 97 such that an edge of proximal surface 97a is received within a recess 142a of grasping pawl 142. In embodiments, the recess 142a is shaped such that if a distal force is applied to actuation shaft 90 when device 10 is in the grasping mode, proximal surface 97a engages an inwardly curved portion of grasping pawl 142 which defines recess 142a of grasping pawl 142 to urge grasping pawl 142 towards the extended position. As described above, in the extended position actuation shaft 90 is prevented from advancing to fire staples. Thus, if a clinician were to push on retraction handle 170 in a distal direction when device 10 is in the grasping mode (for example, to further compress tissue positioned between the first and second jaws 26, 27), the interaction of proximal surface 97a with the curved surface defining recess 142a prevents device 10 from inadvertently shifting into the firing mode.
In the intermediate position of movable handle 19, actuation pawl 140 is prevented from engaging toothed rack 98 of actuation shaft 90. More specifically, when movable handle 19 is in the intermediate position, actuation pawl 140 is positioned to slide along a flat surface 90a (
Referring to
With reference to
Referring to 1-5, when a clinician compresses movable handle 19 from the non-compressed position towards stationary handle 18, moveable handle 19 advances disconnect link 157 to position ramp 158 within slot 152 of vertical pawl 150 to disengage vertical pawl 150 from vertical pawl locking surface 92 of actuation shaft 90. As movable handle 19 is compressed, finger 141 of actuation pawl 140 engages shoulder 96 of actuation shaft 90 to advance actuation shaft 90 distally. Distal advancement of actuation shaft 90 transitions tool assembly 25 to the closed position. Once actuation shaft 90 moves distally such that vertical pawl 150 is positioned proximal to vertical pawl locking surface 92 of actuation shaft 90, actuation shaft 90 is prevented from returning to the retracted position without the clinician actuating retraction assembly 70 as discussed below.
In the grasping mode (
In the grasping mode, the clinician is free to open and close the jaws 26, 27 (
When the clinician moves moveable handle 19 to the non-compressed position, disconnect arm 159 of disconnect link 157 is positioned within slot 152 of vertical pawl 150 such that vertical pawl 150 engages fire mode locking surface 94 of actuation shaft 90 to prevent retraction of actuation shaft 90 such that the jaws 26, 27 of tool assembly 25 remain in a clamped or closed position. Device 10 may also be positioned in the firing mode without entering grasping mode if the clinician holds actuation button 146 depressed to retract actuation arm 144 and then cycles moveable handle 19 from the non-compressed position to the compressed position and back to the non-compressed position such that the vertical pawl 150 engages fire mode locking surface 94 of actuation shaft 90.
To fire staples from cartridge assembly 26 (
After the clinician fires the staples or desires to release the tissue from tool assembly 25, the clinician engages retraction assembly 70 by pulling retraction handle 170 proximally. When retraction handle 170 is pulled proximally, coupling rod 176 moves from its distal position towards its proximal position to cam release plate 172 downwardly below toothed rack 98 as discussed above. When retraction plate 172 extends below toothed rack 98, retraction plate 172 disengages finger 141 of actuation pawl 140 and vertical pawl 150 from actuation shaft 90. Proximal movement of retraction handle 170 retracts actuation shaft 90 and thus retracts control rod 14a to transition tool assembly 25 from the closed position to the open position and release the tissue from within tool assembly 25. When refraction handle 170 is released, retraction biasing member 174 returns coupling rod 176 to the distal position and moves retraction plate 172 above toothed rack 98 allowing device 10 to be reused.
It will be understood that various modifications may be made to the embodiments disclosed herein. For example, it is envisioned that the surgical stapling device disclosed may be used in association with other surgical devices, e.g., clip appliers, dissectors, electrosurgical scaling devices, etc. Further, the device may also include tool assemblies other than staplers or those devices which eject a fastener, e.g., sealing devices (electrosurgical and non-electrosurgical), etc. The button or other actuator for changing the mode of operation for the device may be provided on one side or both sides of the handle assembly. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
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7753245, | Jun 22 2007 | Cilag GmbH International | Surgical stapling instruments |
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7766924, | Jul 28 1999 | Aesculap AG | System for performing anastomosis |
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7815092, | Jul 27 2005 | Covidien LP | Staple pocket arrangement for surgical stapler |
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7819299, | Jun 04 2007 | Cilag GmbH International | Surgical instrument having a common trigger for actuating an end effector closing system and a staple firing system |
7819896, | Nov 04 2002 | Covidien LP | Tool assembly for a surgical stapling device |
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7828189, | Aug 15 2005 | Covidien LP | Surgical stapling instruments including a cartridge having multiple staple sizes |
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7866527, | Feb 14 2008 | Cilag GmbH International | Surgical stapling apparatus with interlockable firing system |
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7909220, | Oct 05 2007 | Covidien LP | Surgical stapler having an articulation mechanism |
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7954684, | Jun 22 2007 | Cilag GmbH International | Surgical stapling instrument with a firing member return mechanism |
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7954686, | Sep 19 2008 | Cilag GmbH International | Surgical stapler with apparatus for adjusting staple height |
7954687, | Nov 06 2007 | Covidien LP | Coated surgical staples and an illuminated staple cartridge for a surgical stapling instrument |
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7967180, | Feb 17 2004 | Covidien LP | Surgical stapling apparatus with locking mechanism |
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7997468, | May 05 2008 | Covidien LP | Surgical instrument with clamp |
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8006885, | Apr 09 2007 | Covidien LP | Surgical stapling apparatus with powered retraction |
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8011550, | Mar 31 2009 | Covidien LP | Surgical stapling apparatus |
8011551, | Jul 01 2008 | Covidien LP | Retraction mechanism with clutch-less drive for use with a surgical apparatus |
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8016177, | May 25 2007 | Covidien LP | Staple buttress retention system |
8016178, | Mar 31 2009 | Covidien LP | Surgical stapling apparatus |
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8028884, | Apr 22 2008 | Covidien LP | Cartridge for applying varying amounts of tissue compression |
8033438, | Oct 14 2005 | Covidien LP | Surgical stapling device |
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8033441, | Oct 06 2006 | Covidien LP | Surgical instrument with articulating tool assembly |
8033442, | Nov 04 2002 | Covidien LP | Tool assembly for a surgical stapling device |
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8038045, | May 25 2007 | Covidien LP | Staple buttress retention system |
8052024, | Jun 03 2005 | Covidien LP | Surgical stapler with timer and feedback display |
8056787, | Mar 28 2007 | Cilag GmbH International | Surgical stapling and cutting instrument with travel-indicating retraction member |
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8061577, | Oct 04 2002 | Covidien LP | Tool assembly for a surgical stapling device |
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8070035, | Aug 15 2005 | Covidien LP | Surgical stapling instruments including a cartridge having multiple staple sizes |
8074858, | Jul 17 2008 | Covidien LP | Surgical retraction mechanism |
8074859, | Mar 31 2010 | Covidien LP | Surgical instrument |
8074862, | Jun 06 2008 | Covidien LP | Knife/firing rod connection for surgical instrument |
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8087563, | Sep 23 1997 | Covidien LP | Surgical stapling apparatus |
8091753, | Oct 04 2002 | Covidien LP | Surgical stapling device |
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8091756, | May 09 2008 | Covidien LP | Varying tissue compression using take-up component |
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8096460, | Oct 05 2007 | Covidien LP | Surgical stapling apparatus |
8100309, | Oct 06 2006 | Covidien LP | Surgical instrument with articulating tool assembly |
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8102008, | Jan 14 2005 | U S BANK NATIONAL ASSOCIATION, AS COLLATERAL AGENT | Integrated circuit with buried digit line |
8113406, | Aug 15 2005 | Covidien LP | Surgical stapling instruments including a cartridge having multiple staple sizes |
8113407, | Aug 15 2005 | Covidien LP | Surgical stapling instruments including a cartridge having multiple staples sizes |
8113408, | Oct 05 2001 | Covidien LP | Surgical stapling device |
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8123101, | Oct 20 2000 | Covidien LP | Directionally biased staple and anvil assembly for forming the staple |
8127975, | Oct 04 2005 | Covidien LP | Staple drive assembly |
8127976, | May 08 2009 | Covidien LP | Stapler cartridge and channel interlock |
8132703, | Sep 03 2008 | Covidien LP | Surgical instrument with indicator |
8132705, | Jun 03 2005 | Covidien LP | Surgical stapler with timer and feedback display |
8132706, | Jun 05 2009 | Covidien LP | Surgical stapling apparatus having articulation mechanism |
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8157148, | Feb 17 2004 | Covidien LP | Surgical stapling apparatus with locking mechanism |
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8186558, | Nov 10 2009 | Covidien LP | Locking mechanism for use with loading units |
8186559, | Jul 12 1999 | Covidien LP | Expanding parallel jaw device for use with an electromechanical driver device |
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8196795, | Feb 14 2008 | Cilag GmbH International | Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus |
8196796, | Jun 04 2007 | Cilag GmbH International | Shaft based rotary drive system for surgical instruments |
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8205619, | Sep 28 2007 | Covidien LP | Method of preventing articulation in a surgical instrument |
8205780, | Mar 22 2007 | Covidien LP | Apparatus for forming variable height surgical fasteners |
8205781, | Sep 19 2008 | Cilag GmbH International | Surgical stapler with apparatus for adjusting staple height |
8210412, | Apr 09 2007 | Covidien LP | Surgical stapling apparatus with powered retraction |
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8235272, | Nov 20 2009 | Covidien LP | Surgical stapling device with captive anvil |
8235273, | Mar 31 2009 | Covidien LP | Center cinch and release of buttress material |
8235274, | Aug 31 2007 | Covidien LP | Surgical instrument |
8236010, | Mar 23 2006 | Cilag GmbH International | Surgical fastener and cutter with mimicking end effector |
8240536, | Mar 15 2007 | Covidien LP | Powered surgical stapling device |
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8245898, | Jul 26 2005 | Cilag GmbH International | Surgical stapling and cutting device |
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8256654, | May 25 2007 | Covidien LP | Staple buttress retention system |
8256655, | Apr 22 2008 | Covidien LP | Cartridge for applying varying amounts of tissue compression |
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8281973, | Oct 05 2001 | Covidien LP | Surgical stapling device |
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8286848, | Oct 05 2001 | Covidien LP | Surgical stapling device |
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8292146, | Aug 15 2005 | Covidien LP | Surgical stapling instruments including a cartridge having multiple staple sizes |
8292147, | Oct 05 2007 | Covidien LP | Surgical stapler having an articulation mechanism |
8292148, | Nov 06 2007 | Covidien LP | Articulation and firing force mechanisms |
8292149, | Oct 17 2003 | Covidien LP | Surgical fastener applying apparatus with controlled beam deflection |
8292150, | Nov 02 2010 | Covidien LP | Adapter for powered surgical devices |
8292151, | Oct 04 2002 | Covidien LP | Tool assembly for surgical stapling device |
8292152, | Sep 23 1997 | Covidien LP | Surgical stapling apparatus |
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8292156, | Oct 14 2009 | Covidien LP | Varying tissue compression aided by elastic members |
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8308040, | Jun 22 2007 | Cilag GmbH International | Surgical stapling instrument with an articulatable end effector |
8308041, | Nov 10 2010 | Covidien LP | Staple formed over the wire wound closure procedure |
8308042, | Jun 18 2007 | Covidien LP | Structure for attachment of buttress material to anvils and cartridges of surgical stapler |
8308043, | May 19 2009 | Covidien LP | Recognition of interchangeable component of a device |
8308044, | Apr 17 2007 | Covidien LP | Flexible endoluminal surgical instrument |
8308046, | Jun 18 2007 | Covidien LP | Interlocking buttress material retention system |
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8322455, | Jun 27 2006 | Cilag GmbH International | Manually driven surgical cutting and fastening instrument |
8322589, | Jun 22 2007 | Cilag GmbH International | Surgical stapling instruments |
8328061, | Feb 02 2010 | Covidien LP | Surgical instrument for joining tissue |
8328065, | Jun 06 2008 | Covidien LP | Knife/firing rod connection for surgical instrument |
8333313, | Jun 22 2007 | Cilag GmbH International | Surgical stapling instrument with a firing member return mechanism |
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8336753, | Oct 04 2005 | Covidien LP | Staple drive assembly |
8336754, | Feb 04 2011 | Covidien LP | Locking articulation mechanism for surgical stapler |
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8342378, | Aug 17 2009 | Covidien LP | One handed stapler |
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8342380, | May 09 2008 | Covidien LP | Variable compression surgical fastener apparatus |
8348123, | Apr 29 2003 | Covidien LP | Surgical stapling device with dissecting tip |
8348124, | Feb 08 2011 | Covidien LP | Knife bar with geared overdrive |
8348125, | Jun 03 2005 | Covidien LP | Battery powered surgical instrument |
8348126, | Mar 31 2009 | Covidien LP | Crimp and release of suture holding buttress material |
8348127, | Apr 07 2010 | Covidien LP | Surgical fastener applying apparatus |
8348129, | Oct 09 2009 | Cilag GmbH International | Surgical stapler having a closure mechanism |
8348130, | Dec 10 2010 | Covidien LP | Surgical apparatus including surgical buttress |
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8353437, | Jun 22 2007 | Cilag GmbH International | Surgical stapling instrument with a geared return mechanism |
8353440, | Sep 21 2007 | Covidien LP | Surgical device having a rotatable jaw portion |
8356740, | Mar 09 2009 | Aesculap AG | Controlling compression applied to tissue by surgical tool |
8357174, | Oct 14 2003 | Single fold device for tissue fixation | |
8360294, | Jan 31 2007 | Covidien LP | Surgical instrument with replaceable loading unit |
8360297, | Sep 29 2006 | Ethicon Endo-Surgery, Inc | Surgical cutting and stapling instrument with self adjusting anvil |
8360298, | Sep 23 2008 | Covidien LP | Surgical instrument and loading unit for use therewith |
8360299, | Aug 11 2009 | Covidien LP | Surgical stapling apparatus |
8365971, | Sep 23 2009 | TOUCHSTONE INTERNATIONAL MEDICAL SCIENCE CO , LTD | True multi-fire linear cutter |
8365972, | Mar 31 2009 | Covidien LP | Surgical stapling apparatus |
8365973, | Jun 03 2009 | TOUCHSTONE INTERNATIONAL MEDICAL SCIENCE CO , LTD | D-shaped surgical staples |
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8371491, | Feb 15 2008 | Cilag GmbH International | Surgical end effector having buttress retention features |
8371492, | Mar 06 2007 | Covidien LP | Surgical stapling apparatus |
8371493, | Mar 06 2007 | Covidien LP | Surgical stapling apparatus |
8381828, | Jul 27 2005 | Covidien LP | Surgical device |
8381961, | Jan 14 2009 | Covidien LP | Surgical stapling apparatus including staple with plate |
8387848, | Aug 20 2009 | Covidien LP | Surgical staple |
8387849, | Apr 11 2008 | BUESSELER, RYAN K ; HOM, DAVID B ; ERDMAN, ARTHUR G | Fastener deployment system and method |
8387850, | Mar 25 2008 | Covidien LP | Surgical stapling instrument having transducer effecting vibrations |
8388652, | May 10 2002 | Covidien LP | Surgical stapling apparatus having a wound closure material applicator assembly |
8393513, | Apr 11 2002 | Covidien LP | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
8393514, | Sep 30 2010 | Cilag GmbH International | Selectively orientable implantable fastener cartridge |
8393516, | Feb 26 2009 | Covidien LP | Surgical stapling apparatus with curved cartridge and anvil assemblies |
8397971, | Feb 05 2009 | Cilag GmbH International | Sterilizable surgical instrument |
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